Background and Purpose— After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective studies. Methods— We used the International Study on Cerebral Vein and Dural sinus Thrombosis, which included 624 patients with CVT followed up for a median of 13.9 months. Outcome measures included all symptomatic VTEs and CVT recurrence. Potential predictors of recurrence, including demographic characteristics, imaging features, thrombophilic abnormalities, other risk factors for CVT, and anticoagulation, were analyzed by Cox survival analysis. Results— Of the 624 included patients, 36 (5.8%) had at least 1 venous thromboembolic event. The rate of VTEs after the initial CVT was 4.1 per 100 person-years. Of all VTEs, 63.2% (n=24) occurred within the first year. Fourteen patients (2.2%) had an episode of recurrent CVT and the rate of recurrence was 1.5 per 100 person-years. Nine (64.3%) of these CVT recurrences occurred within the first year. Male gender (hazard ratios=2.6; 95% CI, 1.4 to 5.1; P =0.004) and polycythemia/thrombocythemia (hazard ratios=4.4; 95% CI, 1.6 to 12.7; P =0.005) were the only factors associated with a significant higher risk of VTEs in multivariate survival analysis. Conclusions— The risk of recurrence of CVT is low but is moderate for other VTEs. Recurrence of venous thrombosis after CVT is more frequent among men and in patients with polycythemia/thrombocythemia.

There has been a growing interest in understanding the interdependencies between urbanisation and mental health. Although transportation in cities is complex and of foremost importance to support the mobility of goods and passengers, little is known about how it relates to individual psychological distress. This review aims to provide an up-to-date synthesis of research evidence about the influence of transport infrastructure and operational performance (congestion, delays and reliability) on mental health/wellbeing. It is structured around three main interacting concepts that determined the search/selection of articles: identification of the above-mentioned transport-related exposures; use of psychological and physiological validated instruments; and the outcome on mental health/wellbeing. Ultimately, 69 studies were identified involving an empirical quantitative focus that met the inclusion criteria. We summarise the instruments most reported in these studies and the findings linking transport indicators and psychological and physiological outcomes. Across the review, we identified evidence of the contribution of key transport infrastructure, congestion and delay indicators on negative affective states and psychophysiological distress. Regarding transport reliability, the scarce number of studies identified did not allow for drawing similar firm conclusions. We conclude by discussing some limitations and providing recommendations for future research and policy-making agendas.

Background: Cities are becoming the socio-economic hubs for most of the world’s population. Understanding how our surroundings can mentally affect everyday life has become crucial to integrate environmental sustainability into urban development. The present review aims to explore the empirical studies investigating neural mechanisms underlying cognitive and emotional processes elicited by the exposure to different urban built and natural spaces. It also tries to identify new research questions and to leverageneurourbanismas a framework to achieve healthier and sustainable cities.Methods: By following the PRISMA framework, we conducted a structured search on PubMed, ProQuest, Web of Science, and Scopus databases. Only articles related to how urban environment–built or natural–affects brain activity through objective measurement (with either imaging or electrophysiological techniques) were considered. Further inclusion criteria were studies on human adult populations, peer-reviewed, and in English language.Results: Sixty-two articles met the inclusion criteria. They were qualitatively assessed and analyzed to determine the main findings and emerging concepts. Overall, the results suggest that urban built exposure (when compared to natural spaces) elicit activations in brain regions or networks strongly related to perceptual, attentional, and (spatial) cognitive demands. The city’s-built environment also triggers neural circuits linked to stress and negative affect. Convergence of these findings was observed across neuroscience techniques, and for both laboratory and real-life settings. Additionally, evidence also showed associations between neural social stress processing with urban upbringing or current city living–suggesting a mechanistic link to certain mood and anxiety disorders. Finally, environmental diversity was found to be critical for positive affect and individual well-being.Conclusion: Contemporary human-environment interactions and planetary challenges imply greater understanding of the neurological underpinnings on how the urban space affects cognition and emotion. This review provides scientific evidence that could be applied for policy making on improved urban mental health. Several studies showed that high-quality green or blue spaces, and bio-diverse urban areas, are important allies for positive neural, cognitive, and emotional processes. Nonetheless, the spatial perception in social contexts (e.g., city overcrowding) deserves further attention by urban planners and scientists. The implications of these observations for some theories in environmental psychology and research are discussed. Future work should take advantage of technological advancements to better characterize behavior, brain physiology, and environmental factors and apply them to the remaining complexity of contemporary cities.